Guest Post: Fertility and Nutrition - The answers to the 10 most commonly asked questions!

Milena Mastroianni, registered nutritional therapist and expert clinician at The Fertility Nutrition Centre, answers the 10 questions she's most commonly asked about fertility and nutrition.

What impact does diet have on fertility, and can diet help improve it?

Good nutrition and a healthy diet can play an important role in changing fertility outcomes for both men and women_[1]. Conversely, a diet based on highly refined and processed foods, as well as high amounts of sugar and soda drinks has been shown to have a detrimental impact on both male and female fertility_[2]. This means that, luckily, you have more control than you think over your fertility destiny by simply deciding to change what you put at the end of your fork (and in your drinking glass!).

What foods help fertility?

There isn’t one particular food that can specifically help with fertility. However, following a Mediterranean diet eating pattern, with plenty of fresh, seasonal fruit and vegetables, wholegrains, nuts and seeds, legumes, eggs, poultry, fish and seafood, as well as extra virgin olive oil has been associated with healthier sperm markers and a higher likelihood of achieving pregnancy and live births_[3][4] in two Greek studies published respectively in 2017 and 2018. Bearing this in mind, personalised nutrition and preconception care, based on targeted testing and assessments, has been shown to be effective as early as 1995, in a study from the University of Surrey, which showed that 83% of over 367 couples became pregnant and carried their babies to full term after following a fertility diet adapted to their specific nutrient and lifestyle needs_[5].

Why is it considered harder for a woman to get pregnant after age 35 and is there anything that can be done to stack the odds in your favour?

As couples choose to start their families later in life, women are often told that their fertility will decline after the age of 35. Whilst this decline in fertility may be due to a lower number of eggs being produced, there is a great deal that can be done to increase ovarian quality within a relatively short amount of time. In fact, we now know that most of the chromosomal (DNA) changes that determine the health and the viability of a woman’s eggs occur during the 90 days prior to ovulation. Therefore, improving the internal and external environment of a woman’s eggs via nutrition and lifestyle changes can really make a world of difference.

My partner has poor sperm quality, is there anything that can be done?

It is well known that male sperm count has consistently declined since the 1970s, and that age, as well as nutritional status and oxidative stress, can also impact sperm vitality and quality. The good news is that what we said about regenerating ovarian health above, applies equally to male sperm. 90 days is all that is needed to make a new batch of healthy sperm. In those three months, optimising lifestyle, nutrition, antioxidant intake, and toxin exposure can all be important steps to future proof and improve sperm health and fertility outcomes.

Can nutrition have an impact in lowering chances of a miscarriage?

Miscarriages can happen for a whole host of reasons, and are often due to chromosomal abnormalities. Investigating the root cause of miscarriages, be it hormonal, immune or nutrient-related, can help reduce the risk of this happening again in the future. Working with a qualified Nutritional Therapist specialising in fertility not only ensures your nutrient stores are fully replete after the sad experience of one or multiple miscarriages, but it can also help you find the answers to the unanswered questions and guide you with in-depth investigations.

What are the most important supplements to consider taking for fertility during the preconception period?

The standard advice given to women who are trying to conceive is to take 400 mcg of folic acid for at least three months during the preconception period, in order to lower the risk of congenital defects and spina bifida_[6]. However, many women carry a genetic modification called MTHFR which doesn’t allow them to convert folic acid into its bioavailable form, called folate. This means that using a supplement that contains folate e.g. in the 5-MTHF form, is a way of ensuring the proper absorption and utilisation of this critical nutrient. As an extra insurance policy, taking a good quality multivitamin containing folate and many other important micronutrients for fertility and pregnancy, like the Inessa Pregnancy Multinutrient, can help support optimal reproductive health and future foetal development.

What other lifestyle factors can have an impact on fertility?

As is the case with many other body systems such as those regulating immunity and digestion, chronic stress can also have a cascade effect on our hormones, which may disturb a woman’s menstrual cycle as well as negatively impacting both male and female libido. When this is combined with lack of sleep, which is also crucial for egg health and testosterone production in men, the effects of chronic stress and sleep deprivation can be catastrophic for fertility. These two adverse lifestyle factors often go hand in hand with high caffeine and alcohol consumption.

Adopting good stress management techniques like meditation, or doing moderate amounts of exercise, as well as maintaining a reliable sleep routine, therefore become as important as nutrition when it comes to positively influencing your fertility journey.

Can nutrition help if I have decided to embark on an IVF journey?

Absolutely! Even though IVF can facilitate the “encounter “of eggs and sperm to improve chances of conception, it does not provide any assurances in terms of egg or sperm health. Similarly to natural conception however, it is important to support both the woman and man’s bodies with the right supplements and nutritional strategies for 3-4 months prior to an IVF cycle. Remember, this is the amount of time needed to mature a new healthy egg and a new batch of good quality sperm, increasing your chances of a successful cycle.

What other areas apart from balancing hormones and reaching a healthy weight can nutrition help with when it comes to fertility?

An area that is often overlooked when it comes to fertility is the one of gut health. We often think hormones are the only ones to blame for our infertility woes. However, the latest research on the gut microbiome, which has exploded in the last ten years, shows that the gut and the microbes residing in it have a direct impact on our reproductive health, ranging from the ability to absorb nutrients to the regulation of hormones and detoxification pathways. Looking after your gut and resolving any potential issues prior to conception may in fact change the course of your fertility journey.

What nutrients do I need to be aware of if I am trying to conceive and I am vegan or vegetarian?

Whilst a plant-based diet is considered beneficial for our gut bacteria and digestion and can help support our health by reducing inflammation and oxidative stress, there are unfortunately a number of nutrients that are not always easy to obtain from a vegetarian or vegan diet. One of the most commonly known is vitamin B12, but iron, omega 3s, choline (if vegan), iodine, vitamin A, and certain amino-acids, are also not easy to obtain in good quantities from plant foods alone, without planning a careful and balanced intake of nutrients_[7]. Taking a good quality multivitamin in this case is essential, as is testing for nutrient deficiencies and adjusting dosages accordingly, ideally whilst working with a qualified nutritional therapist.

Milena Mastronianni is a fertility specialist at The Fertility Nutrition Centre, founded by Sandra Greenbank. Sandra is an expert in proven nutrition strategies to help couples conceive naturally. After 12 years of helping hundreds of couples successfully conceive naturally, she is making it possible for more couples to receive support through the creation of a network of skilled fertility nutrition experts. All experts are fully trained nutritionists who have then undergone further training with Sandra Greenbank, before being included within the directory. For more information please contact www.thefertilitynutritioncentre.org

If you enjoyed reading this article, you might like Six natural ways to optimise male fertility

References

1) Gaskins AJ, Chavarro JE. Diet and fertility: a review. Am J Obstet Gynecol. 2018;218(4):379-389. doi:10.1016/j.ajog.2017.08.010, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5826784/
2) Panth N, Gavarkovs A, Tamez M, Mattei J. The Influence of Diet on Fertility and the Implications for Public Health Nutrition in the United States. Front Public Health. 2018;6:211. Published 2018 Jul 31. doi:10.3389/fpubh.2018.00211
3) Dimitrios Karayiannis, Meropi D. Kontogianni, Christina Mendorou, Lygeri Douka, Minas Mastrominas, Nikos Yiannakouris, Association between adherence to the Mediterranean diet and semen quality parameters in male partners of couples attempting fertility, Human Reproduction, Volume 32, Issue 1, 1 January 2017, Pages 215–222, https://doi.org/10.1093/humrep/dew288
4) Karayiannis D, Kontogianni MD, Mendorou C, Mastrominas M, Yiannakouris N. Adherence to the Mediterranean diet and IVF success rate among non-obese women attempting fertility. Hum Reprod. 2018 Mar 1;33(3):494-502. doi: 10.1093/humrep/dey003. PMID: 29390148.
5) Neil Ward & Keith Eaton (1995) Preconceptional Care and Pregnancy Outcome, Journal of Nutritional & Environmental Medicine, 5:2, 205-208, DOI: 10.3109/13590849509000218
6) Qu Y, Lin S, Zhuang J, et al. First-Trimester Maternal Folic Acid Supplementation Reduced Risks of Severe and Most Congenital Heart Diseases in Offspring: A Large Case-Control Study. J Am Heart Assoc. 2020;9(13):e015652. doi:10.1161/JAHA.119.015652
7) Sebastiani G, Herranz Barbero A, Borrás-Novell C, et al. The Effects of Vegetarian and Vegan Diet during Pregnancy on the Health of Mothers and Offspring. Nutrients. 2019;11(3):557. Published 2019 Mar 6. doi:10.3390/nu11030557